Cervical intraepithelial neoplasia in women infected with human immunodeficiency virus: Prevalence, risk factors, and validity of papanicolaou smears

Thomas C. Wright, Tedd V. Ellerbrock, Mary Ann Chiasson, Nancy Van Devanter, Xiao Wei Sun, New York Cervical Disease Study The New York Cervical Disease Study, Karen Brudney, Pamela Dole, John Koulos, Ralph Richart, Susan Young, Tim Bush, Edward Johnson, George Perez, Carola Marte

Research output: Contribution to journalArticle

Abstract

Objective: To define the prevalence of cervical intraepithelial neoplasia (CIN), the validity of Papanicolaou tests, and the associations between CIN and risk factors for cervical disease in human immunodeficiency virus (HIV)-infected women. Methods: In this cross-sectional study, we enrolled 398 HIV-seropositive and 357 HIV-seronegative women from two HIV-AIDS clinics, two sexually transmitted disease clinics, a methadone clinic, and a clinic for participants in an HIV heterosexual transmission study. Each woman was interviewed and underwent a cytologic and colposcopic evaluation, and was tested for human papillomavirus (HPV) DNA. Results: Eighty (20%) of the 398 HIV-seropositive women compared to 15 (4%) of the 357 seronegative women had colposcopically confirmed CIN (odds ratio 5.7; P <.001). No invasive cancers were found. The sensitivity and specificity of Papanicolaou tests in seropositive women were 81 and 87%, respectively. By multiple logistic regression analysis using a model that included behavioral and biologic risk factors for CIN, CIN was independently associated with HPV infection (odds ratio 9.8), HIV infection (odds ratio 3.5), CD4+ T-lymphocyte count less than 200 cells/μL (odds ratio 2.7), and age greater than 34 years (odds ratio 2.0). Conclusions: Cervical intraepithelial neoplasia is a common finding in HIV-infected women. However, the results of this study suggest that Papanicolaou tests should be effective for detecting cervical disease in this population.

Original languageEnglish (US)
Pages (from-to)591-597
Number of pages7
JournalObstetrics and Gynecology
Volume84
Issue number4
StatePublished - Oct 1994

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Wright, T. C., Ellerbrock, T. V., Chiasson, M. A., Devanter, N. V., Sun, X. W., The New York Cervical Disease Study, N. Y. C. D. S., Brudney, K., Dole, P., Koulos, J., Richart, R., Young, S., Bush, T., Johnson, E., Perez, G., & Marte, C. (1994). Cervical intraepithelial neoplasia in women infected with human immunodeficiency virus: Prevalence, risk factors, and validity of papanicolaou smears. Obstetrics and Gynecology, 84(4), 591-597.